A serious injury of the knee is a tearing of the ACL (Anterior Cruciate Ligament). This ligament is  important for stability of the knee and may need to be repaired surgically. The primary function of the ACL is to keep the bottom surface of the knee joint from sliding forwards during movement. An unrepaired knee may feel unstable or give way suddenly.
 
Not all ACL injuries require surgery and some may heal well with proper rehabilitation, however for those who do need surgery, there is a significant rehabilitation period afterwards.

What does the surgery consist of?
 
Each surgeon will have a slightly different technique for surgery. The most common approach is the arthroscopic approach, which uses a small camera and allows the surgeon to make only small incisions into the knee. They will then replace the torn ligament with either a graft from a tendon or ligament at another part of the body or using a synthetic graft.
 
How long does rehabilitation take?
 
Full rehabilitation following surgery can take 9 to 12 months and is divided into different stages. As surgeons can have different protocols for their approaches to surgery, time frames will vary for everyone. 
 
Initially after surgery, the graft will be quite weak while a new blood supply is being established. It can take up to 12 weeks before the graft is at its strongest point and evidence suggests that it may never have the strength of the original ligament.
 
In the early stages, rehabilitation will be focused on restoring movement to the joint and strengthening the muscles around the knee without putting any undue stress on the graft.
 
As the graft begins to heal and strengthen, rehabilitation can progress to include stability and control exercises and gradually build up to a complex program that prepares the knee for a full return to sport.
 
The path to full rehabilitation from a knee reconstruction can be a long and bumpy one, however, there are high success rates with this surgery, particularly when followed up with full physiotherapy rehabilitation.

There is no doubt that the human body can be resilient. The body is capable of recovering from amazing amounts of damage, including broken bones. Perhaps because of this, some people feel that physiotherapy treatment can only speed up recovery and if they are not elite athletes then simply letting nature take its course is the best, most cost-effective choice for them. 
 
Speed of recovery, however, is only one small measure of physiotherapy success and fails to fully represent how important proper treatment is. Here are a few things about injury healing you may not have been aware of.

1. Scar Tissue is more likely to form without treatment. 
Scar tissue can cause ongoing pain and stiffness in your tissues. Physiotherapy can prevent excess scarring through advice regarding movement, massage and other hands-on treatment. 
 
2. Your ability to sense the position of your body, known as proprioception, is often damaged after an injury and can be retrained.  
Impaired proprioception is a major factor in reinjury. If you’ve ever heard someone say “my knee/ankle/shoulder still doesn’t feel 100%” then this could be why. Physiotherapy treatment will aim to restore proprioception as a part of your rehabilitation. 
 
3. Once healing has finished, your body may not be quite the same as before.  
Injured ligaments may be weaker, damaged muscles and joints may be stiffer and tighter. While the original pain may resolve, there may still be some residual issues that need to be addressed to prevent reinjury. 
 
4. You may have picked up some bad habits while waiting for the injury to heal.  
While in pain we often change the way we do things, which can lead to the development of poor movement patterns and muscle imbalances. Even though the pain has gone, these new patterns can persist and create further problems down the road. 
 
5. Injuries don’t always heal completely. 
On occasion, circumstances may prevent an injury from healing fully. The most serious example of this would be a fracture that cannot heal if the bone is not kept still enough. Other factors that may prevent an injury from healing include poor circulation, diabetes, insufficient care of the injury and poor nutrition. Your physiotherapist can guide you on the best path to a more complete recovery from any injury.

Back pain is such a common experience that it is estimated up to 80% of adults will have at least one severe episode of lower back pain in their lifetime. 
     
For many people, the pain quickly resolves and things go back to normal. However the first time this happens to you it can be scary, particularly as severe pain can occur suddenly and without warning. 
 
Statistics however are on your side. Most of the time, acute low back pain resolves without consequence and doesn’t recur. If you happen to be in the middle of an episode though, here are a few tips to help you get through.

1. Avoid heavy lifting

 
While this may seem obvious, there are a few people who will always try to push through the pain. The expression "no pain, no gain" is in many cases outdated and if your work requires heavy lifting, it is more than reasonable to take a few days off. 
 
2. Avoid too much rest.
 
On the other hand, lying in bed all day is bad for you as well. If you have severe back pain, gentle movement under the advice of a physiotherapist is much better for you than complete rest. 
 
3. Avoid long car or plane trips
 
If possible, now is the time to avoid long distance travel. If you absolutely must travel, speak to your physiotherapist about how to manage your pain during the trip. 
 
4. Avoid listening to horror stories
 
There are always stories about pain that never went away, requiring surgery, which only made it worse. While worst case scenarios can happen, they are rare, and being fearful can negatively impact your recovery. That terrible story is probably not going to happen to you and hearing these stories is only going to worry you and make you feel worse!
 
5. Avoid delaying treatment
 
While your pain may go away on its own, it is important to have a professional assess your condition to screen for any serious injuries and advise you on how to best manage your pain while you are getting better. They can also help you recover as quickly as possible, as well as give you advice on how to avoid future episodes.
 
6.   Don’t expect a miracle cure
 
Back pain is complicated and a single treatment that works for everyone simply does not exist. It is important to follow the directions of your therapist and work with them to set reasonable and realistic goals for your recovery. 
 
None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury. 

There is no doubt that the human body can be very resilient. Short of regenerating new limbs, our bodies are capable of recovering from large amounts of damage, including broken bones. With this in mind, many people are happy to let nature take it’s course following an injury, thinking that seeing a physiotherapist will only act to speed up already healing tissues.
​
The speed of recovery, however, is only one measure of healing and despite our body’s incredible capacity for repair, injury repair can be less than straightforward. Here are a few things about injury healing you may not have been aware of...

1. Scar Tissue is more likely to form without treatment.
Scar tissue can cause ongoing pain and stiffness in skin, muscles and ligaments. Physiotherapy can prevent excessive scarring from forming through advice regarding movement, massage and other hands-on treatment.

2. Your ability to sense the position of your body, known as proprioception, is often damaged after an injury and can be retrained.
Impaired proprioception is a major factor in re-injury. If you’ve ever heard someone say “my knee/ankle/shoulder still doesn’t feel 100%” then this could be why. The good news is that with a specific exercise program, proprioception can be improved and restored.

3. Once healing has finished, your body may not be exactly the same as before.
Following an injury, ligaments may be lax, joints may be stiffer and muscles are almost always weaker. While the pain may be gone, there might still be factors that need to be addressed to prevent more complicated issues in the future.

4. You may have picked up some bad habits while waiting for the injury to heal.
While in pain, we often change the way we do things, this can lead to the development of poor movement patterns and muscle imbalances. Even though the pain has gone, these new patterns can remain and create further problems down the road.

5. Injuries don’t always heal completely.
On occasion, injuries may not be able to heal completely on their own. The most serious example of this is a fracture that cannot heal if the bone is not kept still enough. Other factors that may prevent an injury from healing include poor circulation, diabetes, insufficient care of the injury and poor nutrition.
 
Your physiotherapist can assess your injury and develop a treatment plan that will both restore you to the best possible function and prevent further injuries.